Diseases that affect the heart can also affect the memory. Vascular dementia is a common form of dementia that results in memory loss and confusion due to miniature strokes. These “cortical infarcts” are caused by chronic high blood pressure, diabetes, high cholesterol and/or coronary artery disease.
Causes and symptoms of vascular dementia
Arteries, which are blood vessels that transport oxygenated blood from the heart to the vital organs including the brain, are similar to a straw. If a straw gets clogged a person cannot drink from it because the beverage cannot get past that blockage. This is the same mechanism as vascular dementia; arteries that deliver oxygen-rich blood to the brain become clogged with plaques due to buildup over time. Once the artery becomes clogged, the specific area of the brain supplied by that artery eventually loses its oxygen supply and dies off, resulting in signs of dementia. These plaques or clogs are created by fat deposits from the various clinical diseases that affect the heart and blood vessels. People who have had strokes in the past are at an even greater risk for vascular dementia.
People with vascular dementia commonly have mood and behavior problems along with changes in their memory and cognition. Depression is one of the most common symptoms associated with vascular dementia. Interestingly, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, categorizes vascular dementia as an etiological subtype of either major or mild neurocognitive disorder. In other words, vascular dementia is a cause for neurological deficits.
Diagnosing and treating vascular dementia
Laboratory tests are commonly drawn to rule out reversible causes of dementia. Reversible causes of dementia include vitamin deficiency, alcohol and medication-related causes, metabolic abnormalities such as hypothyroidism, and depression. All of these can cause memory loss, which is reversible. Vascular dementia is not reversible, but can be prevented with good heart health.
Imaging studies such as a brain MRI or CT scan can aid in diagnosis. In a patient with vascular dementia, lesions or infarcts will be visualized on these brain scans. These infarcts represent oxygen-poor areas of the brain. They show up as little white dots to the naked eye.
Although there is no specific treatment for vascular dementia, it can be prevented or stopped. The key is to prevent the underlying causes: Prevent high blood pressure, high cholesterol and diabetes by living a healthy lifestyle, attending regular physician checkups and taking the properly prescribed medications. The risk factors for this disease are directly related to human lifestyle unlike any of the other major dementias.
Psychiatric illnesses such as depression can be debilitating, especially in the elderly. Before rushing to think that depression and cognitive decline are simply a part of normal aging or some type of mental health disorder, keep in mind the different types of neurological dementias. If you or someone you know is battling with depression and/or a substance use disorder, the Dual Diagnosis Helpline may be able to help. For more information, please call 855-981-6047.
Read the previous entry in this series here.